Health status before, during and after disability pension award: the Hordaland Health Study (HUSK).
OBJECTIVE
Up to one in eight of the working age population receives permanent disability benefits. As little is known about the consequences of this major event, analysis aimed to compare health status before and after disability pension award.


METHODS
Data from the population based Hordaland Health Study (HUSK) in Norway 1997-99 (n = 18 581) were linked to official disability benefits registries. The study identified 1087 participants who were awarded a disability pension before, during and after the health survey. These were grouped into different strata defined by temporal proximity between disability pension award and health survey participation. The study then compared health status across these strata covering the 7 years before to the 7 years after the award.


RESULTS
The study found an inverse U-shaped trend with an increase in reported symptoms (anxiety, depression, pain distribution, sleep problems and somatic symptoms) approaching the award, and a reversing of this trajectory afterwards (p<0.05 for the non-linear trend for all symptoms). We found no similar trend for the more objective health measures blood pressure, physical diagnoses and prescribed medication. For most measures, similar levels of health problems were found 3-7 years before compared to 3-7 years after the award.


CONCLUSIONS
When comparing the strata defined by time to the event of disability pension award, there was an increase in symptoms around the time of the disability pension award, with a subsequent return towards pre-award levels. The design precludes any firm conclusions as to what causes the observed results, but possible explanations include temporary adverse health effects from the process itself, the beneficial effects of being removed from harmful work conditions, and recovery after increasing health problems leading up to disability pension award.
Overland
S
S
University of Bergen, Research Centre for Health Promotion, Christiesgate 13, N-5015 Bergen, Norway. Simon.overland@psyhp.uib.no
Glozier
N
N
Henderson
M
M
Maeland
J G
JG
Hotopf
M
M
Mykletun
A
A
D000328:Adult; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D018868:Insurance, Disability / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009664:Norway; D010415:Pensions / Q000706:statistics & numerical data*; D013997:Time Factors; D014478:Unemployment / Q000706:statistics & numerical data